TV
- Image via Wikipedia
More people are complaining about their ingrown toe nails as winter comes and closed shoes are being worn more.
The most common cause of an ingrown toe nail is poor self-treatment, but there are numerous other factors, divided into intrinsic and extrinsic.
Common intrinsic(internal) factors are the basic shape of the nail - especially at the edges – we all have different curvatures and angles and some nails have increased curvature on one side only.
Another factor is the structure and function of the foot (the biomechanics). If a flexible foot rolls or flattens excessively toes can rub against each other, causing pressure. Other factors can be sweaty feet and thin skin, caused by age, medication or circulation.
However, it is the extrinsic factors that really produce the problems – poor self-cutting and shoe pressure top the list. (Sometimes even health care professionals and therapists can cause ingrowns!), tight socks and injuries can also be added to this list.
In the clinic, the appearance of ingrown toe nails varies from a small pink swelling, to an inflamed growth or 'proud flesh', like a small cherry, lying over the nail plate. The pain seems to depend on the individual's pain threshold more than the condition itself.
The offending nail can be just a small 'shoulder', pressing into the sulcus or a sharp spike of nail which penetrates the skin. The skin tries to heal itself when a spike penetrates it and that process leads to the formation of 'proud flesh' or hypergranulation tissue. Of course if the toe becomes infected then pus is also present.
Treatment for ingrown toenails varies with the cause and duration. The simplest treatment is correctly cutting out the offending portion of nail. In the more painful and complicated cases this is done under a local anaesthetic.
The permanent solution under local involves an operative procedure where the complete side of the nail including the matrix, is cut out and the matrix space is destroyed with a strong caustic. After about a month the side where the nail was looks normal – the cavity heals completely. This is a procedure that podiatrists do very well as an outpatient procedure.
Obviously avoiding ingrown nails is the best, but nobody should suffer with them when skilled podiatric care is available.
![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=e887d882-0005-4bc3-8f95-a56798863682)
World Foot Health Awareness Month will be celebrated at the Wits Donald Gordon Medical Centre on Thursday 28th May.
From 09.00 to 12.00 noon, people with diabetes and their families are invited to listen to a talk on diabetes by Dr David Segal and one on the diabetic foot by podiatrist Tracey Johnson. This will be followed by an opportunity to ask questions about diabetes and feet.
If you have diabetes or are family of someone with diabetes – this is for you – so be there!
Sponsored by Sanofi-Aventis; supported by Diabetes SA, I will be there with my colleague Tshidi Tsubane to answer questions too.
POORLY FITTING FOOTWEAR IS A MAJOR CAUSE OF FOOT ULCERATION
Heel pain as a result of Traction Apophysitis is usually debilitating. I wrote about this on 3 April, 11 February and 8 February. The progress report and full case history is now on the website under Case Histories. Although this section is of greater interest to other health professionals, have a look at the X-ray pictures.
They were reported as normal – we could debate that – but what IS important is the improvement in the state of the bone after 3 months of care.
MAY IS WORLD FOOT HEALTH AWARENESS MONTH
Foot Health Awareness is vital for people with diabetes.
PEOPLE WITH DIABETES ARE 25 TIMES MORE LIKELY TO LOSE A LEG THAN PEOPLE WITHOUT THE CONDITION
Today I want to issue a timely reminder to people with diabetes who want to wear 'Crocs'.
Last Friday, I saw a patient who "lived in her 'Crocs'." That was until she got splinters which penetrated the soles and stuck into her big toe, as she was walking across the university campus. The splinters were removed by her GP and today she told me there was a small remaining piece that also had to be removed. Fortunately, although she has neuropathy, the wounds are healing well.
Last Christmas, a family member (with no diabetes) also had a piece of metal go through the sole of his 'Crocs', whilst walking across the garden.
Previously, I have not taken a strong stand on this, but these two events have prompted me to express my opinion in the form of a WARNING.
If you have diabetes, think very carefully about wearing 'Crocs'. If you have poor circulation or reduced nerve sensation; do not wear them outside the home.
EVERY 30 SECONDS A LOWER LIMB IS LOST TO DIABETES SOMEWHERE IN THE WORLD
